正中神经电刺激对颅脑损伤患者脑血流及脑电图synek分级与苏醒效果的影响  

Effect of median nerve electrical stimulation on cerebral blood flow,EEG synek classification and recovery effect in patients with craniocerebral injury

作　　者：杨荣刚 闫峰 沈江宜 YANG Ronggang;YAN Feng;SHEN Jiangyi(Nanyang Nanshai Hospital,Nanyang 473000,China)

机构地区：[1]南阳南石医院,河南南阳473000

出　　处：《中国实用神经疾病杂志》2021年第22期1998-2007,共10页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨正中神经电刺激对颅脑损伤患者脑血流及脑电图synek分级与苏醒效果的影响。方法回顾性分析南阳南石医院2019-01—2021-06收治的119例颅脑损伤后昏迷患者临床资料,其中行常规治疗的56例患者为对照组,常规治疗结合正中神经电刺激疗法的63例患者为研究组,对比2组患者脑血流动力学指标水平、脑电图synek分级、脑干听觉诱发电位(brainstem auditory evoked potentials,BAEP)潜伏期及格拉斯哥昏迷量表(Glasgow coma scale,GCS)评分、脑功能障碍评分(disability rating scale,DRS)。结果治疗后研究组Vm、rCBF、rCBV水平明显高于对照组(P<0.05)。脑电图synek分级主要集中于Ⅲ~Ⅴ级,而治疗后研究组以Ⅰ、Ⅱ级患者居多,且无Ⅴ级患者,同时研究组Ⅰ级患者明显多于对照组,Ⅳ级患者明显少于对照组(P<0.05)。治疗后研究组左右耳BAEP潜伏期相较于对照组明显更短(P<0.05),且GCS、DRS评分改善情况明显优于对照组(P<0.05)。结论正中神经电刺激用于颅脑损伤患者,能够有效提升患处脑血流量,增强大脑血、氧供给能力,改善脑电图synek分级,缩短BAEP潜伏期,促进患者早日苏醒康复。Objective To explore the effect of median nerve electrical stimulation on cerebral blood flow and EEG synek classification and recovery effect in patients with head injury.Methods The clinical data of 119 patients with coma after head injury admitted to Nanyang Nanshi Hospital from January 2019 to June 2021 were retrospectively analyzed. Among them,56 patients who underwent conventional treatment were the control group,63 patients who underwent conventional treatment combined with median nerve electrical stimulation therapy were the study group. The levels of cerebral hemodynamic indicators,EEG synek grades,and brainstem auditory evoked potentials(BAEP)incubation period and Glasgow coma scale(GCS)score,and brain dysfunction score(disability rating scale,DRS)were compared in the two groups.Results After treatment,the levels of Vm,rCBF,and rCBV in the study group were significantly higher than those in the control group(P<0.05);the EEG synek classification of the patients was mainly concentrated in grades Ⅲ to Ⅴ,while the study group after treatment was mainly in grades Ⅰ and Ⅱ,and there were no grade Ⅴ patients. At the same time,the study group had significantly more grade Ⅰ patients than the control group,and grade Ⅳ patients were significantly less than those of the control group(P<0.05). After treatment,the BAEP latency of the left and right ears of the study group was significantly shorter than that of the control group(P<0.05),and the improvement of GCS and DRS scores in the study group was significantly better than that in the control group(P<0.05).Conclusion The application of median nerve electrical stimulation in patients with craniocerebral injury can effectively increase the cerebral blood flow of the affected area,enhance the cerebral blood and oxygen supply capacity,improve the EEG synek classification,shorten the BAEP latency,and promote the patient’s early recovery and recovery.

关 键 词：颅脑损伤 昏迷 正中神经电刺激 脑血流 脑电图synek分级 昏迷催醒 

分 类 号：R651.15[医药卫生—外科学]